Individual
HEATHER MARIE LUPOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1000 EVELYN DR, MILLERSBURG, PA 17061-1258
(717) 232-9971
Mailing address
110 S 17TH ST, HARRISBURG, PA 17104-1123
(717) 232-9971
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN577761
PA
363L00000X
Nurse Practitioner
Primary
SP018894
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103533829-0003
—
PA
05
—
103533829-0004
—
PA
05
—
1035338290001
—
PA
Enumeration date
01/30/2018
Last updated
06/12/2024
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